Information
-
Job name
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
Pump ID:
-
Pump ID:
- 14746- 58M Schwing
- 14735- 58M Putz
- 14750- 47M Putz
- 14730- 46M Putz
- 14737- 42M Putz
- 14351- 40Z Putz
- 14734- 38M Putz
- 14743- 36Z Putz
- 14748- 36M Putz
- 14075- 36M PB
- 14410- 28M Putz
- 14747- 28Z Putz
- 14751- 17M Putz
- 14738- LP
- 14722- LP
- 14399- 40M PB
- 14330- Trailer
- 14799- LBR
- 14781- Screed
-
Operator Name:
- Ed Smith
- Jason Ekins
- Jayson Mathews
- Jeff Anderson
- Kelly Pollock
- Alex Hall
- Todd Hendershott
- Lorenzo Washington
- Mike Kirkland
- Nick Sampson
- Russ Fenner
- Brian Larsen
- Tyler Emond
-
Co-Operator Name:
- Ed Smith
- Jason Ekins
- Jayson Mathews
- Jeff Anderson
- Kelly Pollock
- Alex Hall
- Todd Hendershott
- Lorenzo Washington
- Mike Kirkland
- Nick Sampson
- Russ Fenner
- Brian Larsen
- Tyler Emond
Pump Set Up
-
Cones Set Up to protect from traffic?
-
Outrigger Pads in place with dunnage stacked as needed?
-
Pictures of Set up
-
Safe access to hopper for operator and mixer drivers?
-
Pictures of Access
-
Area under hopper clean and clear of spills?
-
Is radius of pour appropriate for outrigger placement?
-
Does the operator have a safe place to stand that is visible to truck and placement?
-
Clear of all Overhead utilities 20' Min Clearance?
-
Transition guard in place?
-
Safety cables in place at pipe transitions?
Site Conditions
-
Operator has all appropriate PPE on?
-
Proper traffic control in place for pumping operation?
-
Safe access to placement area for crews and operator?
-
Housekeeping?
Clean Up
-
Proper materials available for blow down or clean up?
-
Washout facility on site available and can accept clean out without mess?
-
Signature of Auditor
